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MRI 测量的骨盆测量学参数与机器人经会阴前列腺切除术麻醉参数与手术体位的关系。

Relationship of MRI-measured pelvimetric dimensions and surgical positions with anaesthesia parameters in robotic perineal prostatectomy.

机构信息

Department of Urology. Bakirkoy Dr. Sadi Konuk and Research Hospital. Istanbul. Turkey.

出版信息

Arch Esp Urol. 2022 Jan;75(1):69-76.

Abstract

Theaim of this study was to determine the effect formedby pelvic diameters preoperatively measured throughmultiparametric magnetic resonance imaging (mp-MRI) and different surgical positions on anesthesiaparameters used during perineal robot-assisted radicalprostatectomy (p-RARP). MATERIALS AND METHODS: Six different pelvimetricdimensions were determined preoperatively.Respiratory and hemodynamic variables of the patientswere measured separately and repeatedly in thesupine position, exaggerated lithotomy position at thebeginning of the 15° Trendelenburg position and the60th minute of insufflation. RESULTS: There was a significant increase in thepartial pressure of oxygen (PaO2) in the exaggeratedlithotomy position compared to the supine position.There was no significant change in the partial pressureof carbon dioxide (PCO2) in the exaggerated lithotomyposition compared to the supine position. In the 60thminute of insufflation, there was a significant increasein the PCO2 compared to the supine and exaggerated lithotomy positions. There was no statistically significantchange in the end-tidal carbon dioxide tension(EtCO2), with surgical position or insufflation time. Asignificant negative correlation was observed betweenthe distance of the ischial spines (ISD) and PCO2 change,and a significant positive correlation was observedbetween the angle of the symphysis pubis-seminalvesicles (ASS) and PCO2 change. A significant positivecorrelation was observed between the ASS value andEtCO2 change between the 60th minute of insufflationand exaggerated lithotomy position. CONCLUSION: In our study, the effect caused by differingpelvimetric diameters, surgical positions, andduration of anesthesia during p-RARP on anesthesiaparameters were shown.

摘要

本研究旨在确定术前通过多参数磁共振成像(mp-MRI)测量的骨盆直径和不同手术体位对会阴机器人辅助根治性前列腺切除术(p-RARP)期间麻醉参数的影响。

材料和方法

术前确定了六个不同的骨盆测量尺寸。分别测量并重复测量患者的呼吸和血流动力学变量,仰卧位、15°Trendelenburg 体位起始时的夸大截石位和充气 60 分钟时。

结果

与仰卧位相比,夸大截石位时氧分压(PaO2)显著增加。与仰卧位相比,夸大截石位时二氧化碳分压(PCO2)无显著变化。在充气 60 分钟时,与仰卧位和夸大截石位相比,PCO2 显著增加。呼气末二氧化碳分压(EtCO2)随手术体位或充气时间的变化无统计学意义。坐骨棘距离(ISD)与 PCO2 变化呈显著负相关,耻骨联合-精囊囊角(ASS)与 PCO2 变化呈显著正相关。ASS 值与充气 60 分钟后夸大截石位与 EtCO2 变化之间呈显著正相关。

结论

在我们的研究中,显示了 p-RARP 期间不同骨盆直径、手术体位和麻醉持续时间对麻醉参数的影响。

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